Contractual Relations and its Elements

Como borrar record criminal y consecuencias migratorias

Como borrar record criminal y consecuencias migratorias Es posible borrar o sellar el rà ©cord penal de una persona en Estados Unidos si se cumplen una serie de requisitos.   En este artà ­culo se explica en quà © consiste el borrado del rà ©cord penal, que se conoce en inglà ©s como expungement o sealing, cules son los requisitos bsicos, cà ³mo se solicita y cules son los efectos, incluidas las consecuencias migratorias  de limpiar los antecedentes penales. Quà © es el borrado del rà ©cord penal en Estados Unidos Como regla general, el borrado del rà ©cord penal es el equivalente a su desaparicià ³n, es decir, como si nunca hubiera existido. Es decir, si se obtiene se comunicar a la policà ­a y otra autoridades que se debe sellar este rà ©cord y nadie puede tener acceso al mismo. Sin embargo, es fundamental destacar que en este punto cada estado que compone los Estados Unidos sigue sus propias leyes y en algunos de ellos siempre queda constancia del rà ©cord. Es decir, el rà ©cord no desaparece. Lo que pasa es que sà ³lo se tiene en cuenta si la persona a la que se le borrà ³ el rà ©cord vuelve a tener otro problema con la ley. Por ejemplo, los jueces o las prisiones pueden tener esa informacià ³n. No debe confundirse la eliminacià ³n del rà ©cord (expungement o sealing) con un perdà ³n penal (pardon), que solo puede ser acordado por el Presidente de Estados Unidos, el gobernador o un Consejo especial de Perdones. En este à ºltimo caso sà ­ que hay rà ©cord, pero no se le tiene en cuenta. Sin embargo, en el caso del expungement, es como si no lo hubiera habido nunca.   Por otro lado, en los casos en los que una persona ha sido acusada de una felonà ­a o falta pero se la ha declarado inocente es posible solicitar un Certificado de Inocencia (Certificate of Actual Innocence, en inglà ©s). Requisitos para solicitar el borrado o eliminacià ³n del rà ©cord penal Cada estado regula sus propios requisitos, por lo que hay que verificar la ley del estado en el que tuvo lugar el enjuiciamiento y procesamiento del delito. Pero por regla general, se puede decir que son elementos a favor de que pudiera darse un borrado del rà ©cord cuando se dan 1 o varios de  los siguientes elementos: Si la persona era menor de 18 aà ±os en el momento de cometer el delito o falta.Si ya ha pasado mucho tiempo entre la comisià ³n del delito o falta y el momento de solicitud de borrado del rà ©cord.Si el delito o falta no es considerado como grave.Si la persona que cometià ³ del delito o falta tiene, quitando esa mancha, un rà ©cord absolutamente limpio. Por el contrario, con carcter general puede decirse que no ser posible solicitar un borrado del rà ©cord cuando se dan cualquiera de las siguientes situaciones: La và ­ctima del delito o falta sea un menor de 18 aà ±os AsesinatoViolacià ³n o asalto sexualCiertos delitos que involucren armasObscenidades o pornografà ­a cuando intervienen menores. En este punto es interesante conocer la edad de consentimiento sexual en cada estado, porque relaciones à ­ntimas consentidas entre novios puede dar lugar a que exista delito.Y otros delitos o faltas que fijen las leyes del estado Cà ³mo se solicita sellar o eliminar un rà ©cord penal Sà ³lo un juez de corte civil puede sentenciar que un rà ©cord queda sellado, por lo que hay que iniciar un procedimiento ante dicha corte. Como regla general, no se necesita abogado para esta peticià ³n. Verificar las circunstancias de cada estado. Ventajas de borrar el rà ©cord criminal Existen poderosas razones por las que una persona puede desear eliminar su rà ©cord penal. Por ejemplo, es comà ºn en los Estados Unidos que se pregunte por historial delictivo en los formularios de aplicacià ³n para trabajos o incluso para rentar vivienda. Una respuesta en afirmativo puede resultar que no se obtiene el trabajo deseado o no se puede vivir en el lugar elegido. Sin embargo, si se ha obtenido el sellado del problema penal, se puede contestar sin mentir que no se tiene rà ©cord delictivo. Borrado de rà ©cord y su relacià ³n con Inmigracià ³n A diferencia de lo que aplica en solicitudes de trabajo o de alquiler de apartamentos o casas, en asuntos de inmigracià ³n el expungement no aplica. Esto es asà ­ desde 1999 por una decisià ³n del Board of Appeals (BIA, por sus siglas en inglà ©s) que se conoce como Matter of Roldan. En esa sentencia se decidià ³ que los rà ©cord penales borrados siguen existiendo para Inmigracià ³n. Y esto es importante porque en los formularios migratorios o incluso de visas no inmigrante frecuentemente se pregunta si en el pasado el solicitante de un beneficio migratorio ha sido detenido o arrestado, si ha sido juzgado, si ha sido condenado y si ha cumplido pena de prisià ³n. Existe la obligacià ³n legal de decir la verdad en todos  los formularios de Inmigracià ³n y en las entrevistas con agentes migratorios se est obligado a decir la verdad. Y si se tuvo rà ©cord criminal hay que contestar afirmativamente, aunque à ©ste haya sido sellado. Mentir puede dar lugar a una condena por fraude (misrepresentation).Y esto aplica tanto a delitos o faltas cometidos en Estados Unidos como en otro paà ­s. Por lo tanto, en estos casos lo recomendable es asesorarse con un abogado migratorio, si es posible antes de pedir el borrado del rà ©cord. Y tambià ©n guardar una copia de todos los papeles del problema penal cuyo rà ©cord se borra, desde el arresto a la condena, si la hubo. Pueden ser necesarios en los casos en los que la carga de prueba de que se reà ºnen todos los requisitos para un beneficio migratorio recae en el solicitante. Por otro lado, hay que tener en cuenta que los delitos y las faltas pueden ser causa de inadmisibilidad, esto es, razà ³n para que se niegue una visa no inmigrante o una visa inmigrante u otros beneficios migratorios, como por ejemplo un ajuste de estatus, la adquisicià ³n de la ciudadanà ­a por naturalizacià ³n, la aprobacià ³n del estatus de asilado, etc. Asimismo, pueden ser causa de deportacià ³n, incluso para residentes permanentes legales. Por  todo ello, si se tiene un rà ©cord es conveniente asesorarse sobre si influye en lo que se quiere pedir, ya que no todos los delitos o faltas son iguales ni las circunstancias de cada uno ni lo que se pide ni provocan la mismas consecuencias. Y tener en cuenta que en muchos casos en los que los delitos o faltas son causas de inadmisibiliadd para negar la visa o un beneficio migratorio es posible pedir un waiver, tambià ©n conocido como perdà ³n o permiso. Finalmente, destacar que sà ³lo es posible solicitar la eliminacià ³n del un rà ©cord penal, si se dan todos los requisitos legales. Pero nunca es posible solicitar el borrado del rà ©cord migratorio. Ese siempre est disponible para las autoridades y las personas interesadas pueden solicitar una copia del mismo. Este es un artà ­culo informativo. No es asesorà ­a legal.

Medication Administration Case Study Example | Topics and Well Written Essays - 2000 words

Medication Administration - Case Study Example Hence, this tablet must be taken strictly according to the doctor's instructions. There is no mention about Mrs. Smith's age. If she is elderly with impaired renal function and low lean body mass, she has to take lower dose than what non-elderly patients do. Higher dose intake is known to cause dizziness, eye disorders, cardiac disorders, gastrointestinal disorders, and skin rashes (Lanoxin). Frusemide is used for hypertension as well as congestive heart failure, pulmonary, renal disorder in adults, children and infants. Diuresis is induced in an hour after the intake of Frusemide. Frusemide is rapidly absorbed from the gastrointestinal tract. The dose may comprise 20 mg to 80 mg two to four consecutive days per week, in single dose. If the response is not satisfactory, the dose may be increased by 20 mg to 40 mg after 6 to 8 hours from the first dose intake until the desired dose is established. Symptoms of headache, dizziness, dryness of mouth or visual impairment are known to occur. Patients with cirrhosis of liver are known to develop potassium deficiency. The tablet must be taken strictly under doctor's advice without any chance for overdose (Apo-Frusemide). Span K 600 mg is advised for patients with potassium deficiencies, cardiac failure and hypertension. 1 to 2 tablets are taken three times in a day, preferably during meals. This tablet must be withdrawn at once if there is vomiting or abdominal pains. Caution must be exercised for use for patients with chronic renal disease (Span K). Atenolol 25 mg Atenolol is used in treatment of angina and hypertension. It is also used in treatment to prevent heart attack. This medication must be taken with full glass of water and at the same time every day. Atenolol is only part of a complete program of treatment for hypertension that may also include diet, exercise, and weight control. In case of patients with high blood pressure, it may be necessary to take this drug for the rest of the patient's life. Atenolol can also cause drowsiness, difficulty in breathing, swelling of the face, lips, throat or tongue. If any of these symptoms is noticed, call the doctor at once. Atenolol must be taken exactly as prescribed. Do not stop taking Atenolol without consulting the doctor (Atenolol). Celebrex 100mg SD Celebrex has been used for the treatment of osteoarthritis. It causes reduction in joint pain. Single dose of Celebrex provides pain relief within 30-60 minutes. Celebrex doses of up to 200 mg can be administered without regard to timing of meals. However, care must be taken while administering Celebrex to patients with arthritis. Start use with the lowest recommended dose. Celebrex is known to aggravate hypertension conditions. Also, sometimes, serious gastrointestinal toxicity such as bleeding, ulceration, or perforation of the stomach or intestine has been observed. Patients must stay alert for such symptoms and discontinue use of Celebrex if they occur (Celebrex). Outline if any of these

Clinical Ethics and Ethical Theories Assignment

Clinical Ethics and Ethical Theories - Assignment Example It has three components, namely (a) the key clientele which are elder residents (b) its contribution which is health care, and (c ) distinction which is serving the unique or distinct needs of residents. Needless to say, a mission statement need to be internalized by all health providers in the organization. Unfortunately, however, as in the case with many organizations even in other professional fields, mission statements are emblazoned in marble or metal print outside or inside edifices of organizations, but hardly internalized. Thus, in findings of professional accreditation by duly-authorized accrediting agencies, mission statements are not even in the conscious awareness of company people, being more aware of functions, not a mission. Correctly, the mission forms the standards of behaviour that tell us how human beings ought to act in the many situations in which they find themselves-as friends, parents, children, citizens, businesspeople, teachers, professionals, and so on.â₠¬ (Santa Clara University). In Revera Living, awareness of a formal mission statement which reflects the ethical principles of the organization’s pioneering founders is a reality. ... Integrity pervades the organization in all kinds of interactions for health care from the administrative to the clinical interrelationships. Compassion springs from the Christian culture of the organization wherein the least is regarded with no less care and attention. Excellence refers to the quality of services and is carried through from top administrators at the meso level to the lower echelon health providers at the micro level. On a macro basis, the excellence exuded by Revera Living is aptly demonstrated by the respect given by the state and the community for the residential organization, thereby ensuring it continued public and community support. Taken together, the core values as a framework give evidence of balance and harmony in all the domains of performance. Pointedly asked â€Å"performance of what, and to what ends? Such a question is well addressed in the case of the organization concerned (Onyebuchi, 2011). . Today, the successful experience and expansion of Revera Living to be today since 1996 a leader in Canada and places in the United States bear out the proof of an ethical framework translated into practical social reality. In truth, an ethical framework has turned into an ethical system based on feelings, religion, law, accepted social practice, or science.† (Santa Clara University). The Residents Council and the Family Council at Revera Living further demonstrate that the core of the organization, namely the resident elders and their families equally concretize ethical practice. The Residents’ Council empowers residents along autonomy to determine health care and living conditions. Supporting this internal council is the Family Council in

Federalist Papers Essay Example | Topics and Well Written Essays - 1000 words

Federalist Papers - Essay Example The overall purpose was not only to reshape the constitution of the country but also to ensure the ratification of the US as a combined State. James Madison, Alexander Hamilton as well as John Jay are considered as the authors of these papers though at the time of their publication, the original authorship of these articles were kept secret. Out of all these articles, federalist paper 10 and 51 are considered as most important papers outlining the broader scope and structure of the constitution of the country besides presenting plausible arguments in favor of the formation of one large State. Federalist 10 actually dealt with how to deal with small factions or interest groups and what should be the overall structure of the State to overcome or control such factions. It is written in continuation of the Federalist 9 and also outlines as to how the existence of such groups can tear apart the whole republic. Federalist 51 discusses as to how an effective system of checks and balance as well as the separation of the powers within the government. This paper will therefore discuss both these papers and will explore some of the key arguments made in these papers. Federalist # 10 Federalist 10 discussed extensively the role of the factions and how they can actually damage a republic. Madison was of the view that there are two ways through which such factions can be dealt with. He was of the view that either the very cause of the factions should be removed or the damage caused by such factions should be controlled. 1. His arguments therefore were largely in favor of how to balance both the aspects of factions and devise mechanism to deal with them. One of the key arguments made by the Madison outline that such factions cannot be eliminated altogether because majority can also form such factions. The republic according to Madison however, should be large and diverse enough while at the same time maintain the enough commonality. Madison argued in this paper that a direct democracy would be necessary in place of indirect democracy. Further, he was of the view that the representative democracy should be implemented in order to protect the interests of the individuals from the majority rule. (Meyerson, 2008) The role of anti-federalist however, should also be taken into consideration in the wake of their overall stance on the formation of a central authority. Madison throughout this paper argued that the formation of a large republic is essential in order to control the influence of such faction groups. Anti-federalists also argued that a diverse republic would be difficult to survive and therefore advocated giving more powers to the States based on the notion of locality. (Amar, 1993) The arguments of the anti-federalist can also be considered as interesting in the sense that they argued that the states a large state of the size of United States would eventually fail. As such the notion that a large republic is necessary in order to control the influe nce of the factions would not provide any credible or long term solution to the problem. Anti-federalist view also holds that if the republic is consolidated and a larger State is created, the overall chances of the representation of the people would be reduced. They argue that its through local participation that the representation of citizens could be ensured. In nutshell, Federalist 10 argued that the factions and their influence in the society and political activity could be controlled through the creation of a larger republic managed through representative democracy. Federalist#51 Federalist 51 is another important essay in the series of Federalist Papers outlining the need to have a proper check and balance system. Further it also outlines

Long Bone Fractures in Children: IN Fentanyl Treatment

Long Bone Fractures in Children: IN Fentanyl Treatment Introduction The clichà © that states children are just small adults is certainly not true in the case of long bone fractures. A childs experience of long bone fractures is dramatically different from that of an adult on account of their rapidly developing physiology (Wood et al 2003). This rapid development results in biochemical and physiological differences between a childs and an adults skeleton, the mechanisms of fracture and healing, are an important component of their treatment needs and consequently crucial part of emergency care management (Bonadio et al 2001). In addition, children, from infancy through to adolescence, have common fracture patterns related to their stage of development. The structural differences between the bones of a child and an adult enable childrens bones to endure greater forces and to heal quicker a childs remodeling potential supports full recovery with limited or no long term side effects from long bone fractures (Lane et al 1998). Injuries of all types are the second leading cause of hospitalization among children younger than 15 years (Landin 1997). Musculoskeletal trauma, although rarely fatal, accounts for 10% to 25% of all childhood injuries (McDonnell 1997, Landin 1997, Lane et al 1998). Boys have a 40% risk and girls a 25% risk of incurring a fracture before the age of 16 years (Landin 1997, Ritsema et al 2007). The most common site of fracture is the distal forearm which accounts for 50% of paediatric fractures. The rates of fracture increases with age as children grow; peaking in early adolescence. Fortunately, most fractures in children are minor greenstick and torus fractures constitute approximately 50% of all fractures in children (Landin 1997, Lane et al 1998, Gasc Depalokos1999, Richards et al 2006) and only 20% require reduction. Thus, the management of paediatric fractures is often straightforward. Without exception children will experience pain at the time of injury, attending the accident and emergency department and during recovery. The most common pain management strategies involve a multi-modal approach that includes both pharmacological and non-pharmacological components delivered via the least invasive technique (Worlock et al 2000). In practice this includes oral medication, such as oramorph, paracetamol, and NSAIDs, inhaled entonox, intranasal diamorphine (IND) or intravenous opioid where necessary and distraction with age appropriate devices, such as interactive books, bubbles, music and computer games in older children. Notably, IND is currently embraced as the key route of opioid delivery for children attending AED with fracture pain in the UK British Association for Accident and Emergency Medicine (BAAM E 2002). Parents and guardians of children frequently seek care in AED for the relief of pain from traumatic injuries and as a result the field of emergency medicine has assumed a leadership role in paediatric pain management. However, despite this the literature suggests the provision of pain relief for children attending AED remains suboptimal when compared to adults with the same injuries. Further discrepancies are reported between paediatric accident and emergency departments (PAED) and district general accident and emergency departments (DGAED) (Emergency Triage 2004). One reason suggested for these differences is the geographic distribution of specialised services, which are predominantly located in large cities where they are affiliated with universities. However, a recent audit by the British Association for Emergency Medicine (BAAEM 2005) of their guideline for the management of pain in children shows inconsistencies in provision of analgesia particularly for fracture pain throughout the country with no measurable difference between PAED and DGAED. A key feature of this guideline is the algorithm which advocates the use of IN diamorphine for acute moderate to severe pain in children over the age of one year (see appendix 1). The whole topic of analgesia in the paediatric population is complex and still imperfect especially in acute moderate to severe pain requiring urgent treatment in the emergency department (Schechter et al 2002). The road to pain free suffering is still paved with impediments such as failure of pain recognition and methods of delivery of analgesia (Murat et al 2003). Oral administration can be inadequate in an emergency situation with particular limitations in potential choice of drug and delay in gastric absorption and gastric emptying. Intramuscular (IM) and intravenous (IV) administration can be distressing to children and have been shown to influence future response to painful procedures (Gidron et al 1995, McGrath et al 2000, Fitzgerald et al 2005, Walker et al 2007). Rectal administration has limited acceptability given unpredictability of onset together with occasional problems of consent (Mitchell et al. 1995). By contrast, the efficacy and safety of the IN route has been well documented for desmopression acetate (DDAVP), insulin, antihistamines, midazolam and calcitonin (Jewkes et al 2004, Loryman et al 2006). In contrast, intranasal administration has a number of advantages. It is technically straightforward, socially acceptable and demonstrably effective. The nasal mucosa is richly vascular and administration by this route avoids the first-pass metabolism phenomenon Summary Studies in the 1990s such as Yearly Ellis (1992) have also demonstrated the efficacy of administration of intranasal medication via a nasal spray rather than drops in adults, although the efficacy of this application in the paediatric population remains to be proven. Intranasal administration is possibly the ideal route of analgesic administration in children. Currently, within the accident and emergency department (AED) of Bristol Royal Hospital for Children (BRHC) intranasal diamorphine is used as the first rescue analgesia in the paediatric population presenting with acute moderate to severe pain, most frequently in patients with long bone fractures who do not require intravenous access for resuscitation. Diamorphine is a semi synthetic derivative of morphine with a number of properties that render it a desirable analgesic agent for administration via the nasal route. It is a weak base with a pKa of 7.83 and is water soluble allowing high concentration to be administered in small volume (Rook et al 2006). Unfortunately the legal use of diamorphine is limited to two European countries i.e. United Kingdom (UK) and Sweden. Furthermore periodic problems with its availability during the past few years (with further shortfalls in availability predicted by the NHS purchasing and supply agency) have resulted in an alternative efficacious analgesia being sought for this population. Fentanyl, however, is a short rapidly acting opiate has several qualities that render it useful as an IN analgesia and a potential candidate to replace IN diamorphine in the AED for acute facture pain management in children. It has a very high lipid solubility, potency and diffusion fraction, and unlike diamorphine it is not a prodrug and does not cause histamine release (Reynolds et al 1999). Assessment of a patients pain experience is not directly accessible to others, collecting and analyzing information about the processes of pain relief and pain prevention is not straightforward and presents significant challenges to health care professionals. In children, this task is further complicated by their varied stages of physical and cognitive development. Recent research by Bruce Frank (2004) however, has shown that the ability to measure pain in the paediatric population has improved dramatically and that today there now exists a plethora of age appropriate pain assessment tools for acute pain in children ranging from pre-term infants to adolescents, the majority claiming validity (strength and robustness) and reliability (consistency). However, most clinical research into pain management strategies continue to rely on the gold standard self report and visual analogy score tools (mostly 0-10) (Chalkiadis 2001, Walker et al 2007). Although these tools are reliable they are not always adapted appropriately for a childs stage of development. Childrens understanding of pain and their ability to describe pain change with increasing age in a developmental pattern consistent with the characteristics of Piagets preoperational, concrete operational and formal operational stages in cognitive development (Smith et al 2003). The quality or int ensity of the pain can be difficult to determine in children, as most tools rely upon a patients relative judgment between the intensity of present pain versus a patients worst pain experience (Murray et al 1996). These tools can therefore be unreliable where a childs age of development means they have limited or no memory of pain experience. Stevens et al (2002) recently described a conflict of understanding that resulted in a study bias and an insignificant reported power of (p=0.6). In the study an 8 year old boy had chosen the VAS (0-10) but frequently reported his score as 10, although he understood the increasing value of the scoring system further questioning identified he perceived 10 of 10 to be a good score and 0 of 10 to be poor. The boy was at a stage of development that limited his understanding of less is more. This case highlights the importance of utilizing a pain assessment technique that reliably accounts for a childs age of development. A preliminary search of literature suggests there is currently exists limited research to support for the use of intranasal diamorphine or intranasal fentanyl for the management of acute pain in long bone fracture in children as evidenced based medicine. Despite this lack of evidence it remains a key strategy within paediatric AED for the pain management of long bone fractures and is anecdotally reported as a gold standard for paediatric pain management. Therefore; its lack of availability could profoundly compromise pain management for this population. Thus, this extended literature review will examine the efficacy of intranasal fentanyl as an alternative to intranasal diamorphine for traumatic fracture pain in children attending accident and emergency departments. However, in these days of evidence based medicine, it clearly needs to be established beyond all reasonable doubt. In view of that only research into paediatrics will be included increasing the credibility of its applicat ion to practice. SEARCH STRATEGY A range of complimentary search techniques were used to capture key research including a systematic electronic literature search of the Cochrane library, Embase, CINAHL, Proquest, Medline, PubMed since 1990 up to 2009 (this has to be to year of submission). The scope of the search was extended beyond the recognised five years of current research so as to include the empirical work into the development of IN analgesia in children. Key words used included the following: pain, acute pain management, intranasal diamorphine, intranasal fentanyl, procedural, accident and emergency, emergency department, child, pediatric, paediatric, child and fracture pain, as well as various combinations. In addition, in order to ensure the completeness of the search, an internet search was completed using the Google search engine, IASP, Pain Journal, Paediatric Nursing, BAAEM, NICE, Medline, EBM; the RCN was also utilised. Backward chaining of references found was also performed to ensure all relevant papers were identified. Although this review identified twenty seven citations it should be noted that historically there are fewer Randomised Controlled Trials (RCT) in children compared to adults possibly due to problems gaining ethical approval and consent. Additionally even experienced researchers will be unable to find all relevant papers and much research is not submitted for publication. The studies identified were divided into the three modalities of IN route, IN diamorphine and IN fentanyl with the majority presenting evidence for the IN route. All papers were critiqued using a tool published by the Learning and Development Department within the Public Health Resource Unit of the NHS (www.phru.nhs.uk/casp). The tool facilitated critiquing different forms of quantitative research and is based on work by Sackett (1986), Sackett et al (1996) and Phillips et al (2008) (see appendix 2). The results of the critique process for each paper and level of evidence applied in line with the modalities they address informed understanding of current practice and development of a research proposal. STRUCTURE OF THE LITERATURE REVIEW This literature review will focus on determining whether IN fentanyl is an effective alternative to IN diamorphine for the management of long bone fracture pain in children attending an AED. The scope of the literature review considers literature from 1990 onwards although occasionally earlier research has been referenced. Given the limited available evidence on the topic the following review structure has been selected. Chapters 1, 2 3 will present the evidence sourced on each theme intranasal route, intranasal diamorphine and intranasal fentanyl with a short summary to conclude each chapter. Chapter 4 will present an in-depth discussion and conclusion on the utility of the evidence, its application to practice and the requirement for a multi-centred comparative randomised control trial to improve the credibility of the evidence base for this field of treatment. Finally chapter 5 will present a research proposal for a comparative study of these modalities. Intranasal (IN) route of medication delivery in children. Nasal administration of drugs has been reported as having several significant advantages over current practice which are predominately oral, IM, IV and rectal (Williams Rowbotham 1998). It is emerging as a low-tech, inexpensive and non-invasive first line method for managing either pain or other medical problems (Wolf et al 2006). Nasal medication delivery takes a middle path between slow onset oral medications and invasive, highly skilled delivery of intravenous medications. The nose has a very rich vascular supply, IN facilitates direct absorption to the systemic blood supply due to increased bio-availability of the drug by missing first pass metabolism, It avoids the potentially technically difficult of sterile intravenous access, is essentially painless and is considered acceptable to children when compared to other routes of administration (Shelly Paech 2006) (see table 1). a theory which will be considered when reviewing the studies within this chapter Therefore suggesting th e IN route will result in therapeutic drug levels, effective treatment of seizures and pain without the need to give an injection or a pill, furthermore; it is quite inexpensive, an advantage in this era of increasingly expensive medical technology (Shelly Paech 2006). Additionally given the complexity of the developing child and the known consequence of poorly managed pain on the future responses to pain the IN route does, if it is as efficacious and as safe as suggested offer one of the most acceptable, definitive forms of analgesia delivery in children. The degree of accuracy of the previous statements will be established within this chapter by critically reviewing the 16 studies identified on IN medications other than intranasal diamorphine or intranasal fentanyl in the paediatric population (see table 2) as these agents are considered individually in later chapters. The rigour of the studies will be addressed within this chapter and reflect the level of evidence applied according to Sackett (1986) criteria (see appendix 3). Most studies reviewed were randomised clinical trials and in some cases compared against a placebo Conversely, this does not concur with the trials discussed earlier (Lahat et al 1998, Al-rakaf et al 2001, Fisgin et al 2002, Mahmoudian and Zadeh 2004 and Holsti et al 2007) where significant dosing was applied or in Wilson et al (2004) who retrospectively studied 30 children age 2-16 years receiving 0.3mg/kg at 5mg/1ml INM and 13 patients receiving rectal 0.2mg/kg diazepam for seizures. The authors report equal efficacy for both routes. Success of these agents was considered on cessation of seizures, no reported complication and not needing to attend A+E. A total of 27/30 families who had used INM found it effective and easy to use. Although 20/24 (83%) who had previously used rectal diazepam still preferred it mostly due to the coughing and the volume of liquid administered via the IN route. Given it is generally considered that the optimum IN dose as stated above is 0.1- 0.2 ml per nostril, all but the studies discussed so far were using drug concentration and dosing regimes whic h resulted in large volumes of liquid being dripped in to the nasal cavity. This is particularly poignant in Wilson et al (2003) who compared buccal to IN midazolam in 53 children aged 3-12 years experiencing seizures lasting > 5 minutes attending AED. A key feature of this study is the mean age of the children (age 9 years), mean weight (24kg) the study drug concentration as with previous studies was of 5mg /ml. IN dosing was at a dose of 0.3mg/kg. Given these figure the average dose would have been 7.2mg = a volume of 1.4ml being administered. Since the comparative route of administration for this study was buccal there is a possibility that part of the IN dose was buccally absorbed therefore creating a flaw in this study methodology, raising questions over why this comparative route was chosen and suggesting the only real conclusion to be taken from this particular study is buccal midazolam is effective and safe in children. Furthermore although this is described as a blind RCT and the authors claim the time to cessation of seizure was quicker for the INM group 2.43 (SD 1.67) to 3.52 (SD 2.14) for buccal route there is little detail on the blinding process or data collection procedure suggesting the rigour of the study maybe flawed therefore the efficacy and safety claimed for the IN route should not be embraced without further study. On the other hand Fisgin et al (2002) and Hardord et al (2004) compared the INM with rectal diazepam. In Fisgin et al (2002) in an unblinded RCT equivalence study the authors compared INM with rectal Diazepam to ascertain the safety and efficacy of INM for the development of a clinical protocol in the management of prolonged seizure in children attending the AED. Forty five infants and children age 1 month -13years experiencing prolonged seizures > 10 minutes were either given INM 0.2mg/kg or rectal diazepam 0.3mg/kg. The authors report proven efficacy (p Intranasal Diamorphine (IND) The delivery of opioids via the IN route is perhaps one of the most valuable indications for IN medication delivery. Acute pain is a frequent experience for children whether attending an AED, hospital and hospice setting (Hamer et al 1997). Furthermore it is not unusual for them to experience frequent episodes of breakthrough pain which requires additional support from fast acting analgesic agents. Owing to the developmental and physiological difference in the paediatric population there is a need for a variety of effective treatment option from which to select and individualise the patients therapy to meet their needs. IN opioid is simply one such option available which may be useful in children. It has been suggested that the delivery of medications via the IN route results in rapid absorption with medication levels within the cerebral spinal fluid (CSF) being comparable with (IV) administration (Chien and Chang 1997). Diamorphine hydrochloride is a semi-synthetic derivative of morphine. It is extremely hydrophilic, which makes it ideal to use when preparing in high concentrations in solution, thus allowing high doses to be administered in smaller volumes via the intranasal route (Kendall Latter 2003). However, this route of administration can be a painful process as reported by adults (Henry et al 1998). Despite this the intranasal route is considered more acceptable to children and their parents and is thought to lessen the opioid side effect profile seen in IV administration (Stoker et al 2008). This concept has been well recognised throughout the UK and many centres already use intranasal diamorphine for acute pain in children, following the guidelines by the British Association for Accident and Emergency Medicine Clinical Effectiveness Committee (2002) (BAAEM). Although the administration of intranasal diamorphine is now a first line choice for moderate to severe acute pain for children atten ding AED, as is the case within our institution, there is very limited research to substantiate this practice although as noted above it has been readily accepted by the BAAEM for acute pain management in children and very successfully used within our institution A recent shortage of diamorphine evoked the search for an equally effective and acceptable alternative. Early research in animals and adults reported pharmacokinetics of nebulised inhalation and intranasal administration of diamorphine as detected morphine in plasma at six minutes (Masters et al 1988, Kendall 2001). Despite the age of this research and the fact that the later study was in adults, it is still quoted as creditable evidence to support this practice in paediatrics. However the legitimacy of this should be questioned, due to children not being just small adults but have physiological differences intrinsic to their age and stage of development which may affect the bodys absorption and level of toxicity in different ways to adults. The extensive literature search highlighted four randomized controlled trials (RCT) that demonstrate IND to be clinically superior to intramuscular morphine and inferior to IV morphine particularly in the management of acute pain in children, a case study of an 8 year old boy and clinical audit of IND for pain relief in children attending AED (see table 3). The key methodology in the RCTs by Wilson et al (1997), Kendall et al (2001), Brennan et al (2004) and Brennan et al (2005) suggest these are superiority studies where the authors hypothesised improved pain management with the IND when compared to a variety of routes. The rigour of the studies will be discussed later in the chapter. Although while the critiquing process takes place it is fundamentally accepted that RCT are considered level 1 or 2 evidence as opposed to case study or audits at Level 3b and therefore generally sourced to Latest published clinical evidence to support the use IND in the paediatric population is presented in an audit by Gahir Ranson (2006) of 54 children whose care was managed by the use of an integrated care pathway for acute pain management while attending the local AED. This integrated care pathway focused strongly on the use of IND. Data collection was on a one page performa and included consent, date, patient demographic, pain score and side effect profile. Data collection was retrospective and data analysis illustrated limited recording of side effect profile but improved pain scores. However only 60% of patients have this information documented so data collection was difficult. Despite this lack of hard evidence no clinical incident, including the side effect profiles, were reported. Thus suggesting the practice of IND for acute fracture pain management in children could be safe, effective and more acceptable to children than the more painful alternative of IM or IV administration. However there is limited strength in an audit, other than a review of practice (Bowling Ebrahim 2005) and in this case a key feature for review should be the documentation process in the department as there were facets in the care pathway administration documentation missing. Therefore this audit suggests that IND is safe and effective pain management for children, but this conclusion can not be categorically drawn from the limited data available. The potential outcome of this audit could be education on documentation, to do a more rigours prospective audit of practice. Unfortunately at this point it only offers an insight to their clinical practice which is favourable for this agent and route. Albeit as noted before IND has improved childrens pain management and over all experience of acute care in our PAED additionally as with the results of the audit we have experienced no side effects or complications, further highlighting the importance of seeking an alternative to IND which offers equally efficacy. Intranasal Fentanyl (INF) Monitoring of the usual observations and pain scoring in the child was recorded prior to the administration of fentanyl (20 micrograms for 3-7 year olds and 40 micrograms for 8-16 yrs) and continued at 5 minute intervals for the 30 minute period. Additional doses of fentanyl (20  µg) were available if required at 5 minute intervals. Pain assessment was achieved with two validated pain assessment tools, the visual analogue scale (VAS) in older children and the Wong-Baker Faces (WBF) for younger children. Both are reliable and known to support consistency in pain assessment. Though there was no mention of training for those assessing this primary end point using these tools in the paper therefore this should be considered in the overview of the standard of evidence produced by this study. Additionally although forty five patients were randomized following consent unfortunately no details on the randomization process was disclosed in the paper either. This may not be significant, but when reviewing the credibility of the authors claims these obvious omissions could be responsible for a flaw in this study and remains to be established. On the other hand, the methodology that has been disclosed in the paper appears sound as it addresses key areas of sample calculation (power of the study) as a superiority study with the sub groups size adequate to detect a significant difference (Greenhalgh 2004); demographics, blinding of the drugs, assessors and appropriate statistical analysis of the data therefore supporting the validity of the results claimed and the application of the results to the age of patient targeted that this literature review is aiming to find an analgesic alternative to IND for. The results concluded by Borland et al (2002), are a reduction in pain score at 10 minutes to 44.6 mm (95% confidence interval) 36.2-53.1 mm from 62.3 mm 53.2-69.4 mm (95% confidence interval) at assessment using the VAS and 2.2 (95% confidence interval 1.3-3.1) at 10 minutes from 4.0 (95% confidence interval 3.3-4.7) at assessment in 16 children using WBS. Visual analogue pain scores demonstrated clinically significant reductions in pain scores by 5 minutes that persisted throughout the entire study (up to 30 minutes) for both INF and IV morphine. The second primary end point of this study (side effect profile) showed no significant change in physiological parameter of the childrens pulse or respiratory rate, blood pressure or oxygen saturations, interestingly the side affect profile chosen for monitoring such as pulse and blood pressure are not considered to be one of the primary side affects of morphine, however nausea and vomiting which are was not assessed. Ultimately, there wer e no negative side-effects and the sizeable reduction in pain scores (compared to baseline assessments) was accomplished in children using INF by 10 minutes and maintained throughout the 30 minute period with the mean INF dose at 1.5 µg/kg and ranging from 0.5-3.4  µg/kg. Interestingly 35.5% of children in the INF group only required one dose. Given the clinical equivalency of these two agents and routes the authors conclusion that INF offers the benefits of a simple painless technique for treating acute pain is substantiated. These benefits suggest that the IN route could be a valuable technique not only in an AED but also for breakthrough pain by offering a fast onset of pain control in moderate to severe painful conditions. It could also provide pain relief and allow topical anaesthetics to take effect on the skin prior to IV establishment. Therefore this may be a suitable alternative to IND. A similar and more recent double blinded RCT trial by Saunders et al (2007) claimed efficacy of a larger dosing regimen with a mean dose of 2 µg/kg INF (50 µg/ml) for pain reductions in paediatric orthopaedic trauma compared with IVM at 0.1mg/kg in 60 3-12 year old children. This study reports positive outcome for INF following both patients and carers reporting very effective pain management and satisfaction using this treatment method. However there is little information in the paper of methodology and results are given in percentages rather than a P value or NTT which should be expected in a rigorous creditable RCT of two agents (Bowling Ebrahim 2005) reducing the level of evidence applied to the paper to L3. Even supposing the results are an accurate reflection of the efficacy and safety of INF, particularly the fact that no significant difference in pain score or side effect profile and INF is a way forward, the lack of detail the randomisation process and analysis of data in the study methodology merely implies that these results maybe flawed. Interestingly given the concentration of fentanyl 50 µg/ ml a dosing volume for a 25kg child would have required one ml = 0.5ml per-nostril therefore suggesting some of the administration may have been oral rather than IN and present the issues of bad taste which is put forward as a possible study limitation by the authors. Then again there are no complications or reports on taste presented in the results and the authors conclusion on the efficacy of INF for acute pain management in children may be founded. However, without sourcing more details from the authors it cannot be considered evidence to inform this dissertations aims but merely an ex ample of poor research or appropriate omission by publishers. Further suggesting there remains a requirement for more research on the topic within double blind, equivalence, RCT focused on INF efficacy and dosing with sound methodology that is transparent in publication to answer the dissertation question. Conversely an older and more rigorous study which also looked at dose related analgesic effect between routes of administration is by Manjushree et al (2002). The authors demonstrated the clinical efficacy of INF in a cohort of 32 children (aged 4-8 yrs) in a postoperative situation and with a double blind level 1 RCT. The study design gives the impression of sound methodology as blinding, assessment and analysis of data was appropriate and available for scrutiny in the paper, particularly the analysis of both nonparametric and nominal data. The only weakness is possibly the sample size of 32 patients. Although the authors performed a power calculation which identified 40 patients to show a significant affect, they only recruited 32 patients, furthermore, this appears to be an equivalency study where the authors hypothesised INF would be equal to and not inferior to IVF therefore would have needed a larger sample to de

Black Education in New York City during the 1830s Essay examples -- Af

An 1831 editorial in The Liberator made the perceptive observation that â€Å"a line, almost impassable, [was] drawn between the two races.†One might say that the â€Å"problem of the color line† had actually been identified over seventy years before W. E. B. Du Bois diagnosed it in 1903.The same editorial continued, â€Å"by law, or by custom, in much . . . of the country, [blacks] are in a great measure deprived of the lessons of education.In most . . . states they cannot vote, or be chosen to office.If aliens, they cannot be naturalized. . . . [Blacks] cannot mingle in society with . . . whites.†[i]Blacks were treated as second-class citizens.However, by the early 1830s northern blacks were deciding, whether it was in Boston, Philadelphia, Baltimore, or New York City, to actively challenge the racism within American society institutionally and lay claim to all the privileges of American citizenship.Various factors made the 1830s the decade when blacks would or ganize around education in an attempt to redraw the parameters of American citizenship.Among these were: emancipation in New York State in 1827, the founding of African American newspapers, abolition, and a strong commitment to the ideals of the Declaration of Independence and the U. S. Constitution. The emergence of a more militant abolitionist movement early in the decade refocused the northern antislavery struggle on the desire for immediate abolition and enlarged the arena for blacks to participate in civil society.However, in addition to participating in white antislavery organizations, such as William Lloyd Garrison’s American Anti-Slavery Society, black leaders advanced their own case for abolition through independent educational efforts.They knew that the main argument against... ...ed people† could see only African colonization as the solution for racial animus and black elevation.And African Americans were largely denied the opportunity to pursue education beyond the primary level.Middle-class blacks that did attempt to integrate themselves into the larger society were rebuffed at almost every turn, as they were often not accepted into white benevolent organizations, schools, or literary societies. The black community in New York City did not simply accept the current state of affairs with resignation.They believed that they, too, were included in the covenants that were the Declaration of Independence and the Constitution.As white political elites sold the widened electorate rhetoric of egalitarianism, black leaders took the claims of the equality of all humanity to heart and attempted to put the moral conscience of the nation to the test.

Pride and Prejudice and the Relationships of Women and Men Essay

In the book Pride and Prejudice by Jane Austen there are many relationships between men and women. This book was originally entitled First Impressions and when reading it is easy to understand how this title could be aptly appropriate to the story line and characters. In these relationships one of the things that can be noted is that men are primarily looking for sex and that women are looking for resources. There are several character relationships in the story that exemplify this theory. These relationships include the relationship between Charlotte and Mr. Collins, Elizabeth and Mr. Darcy, and Mr. and Mrs. Bennet. There are many examples as to how these relationships truly do exemplify the theory that women use relationships to find resources and men use relationships to find sex (LeFraye, Chapter 1). In the relationship of Charlotte and Mr. Collins there is much speculation throughout the story as to whether or not they are really in love. This can be exemplified through looking at their interactions together and focusing on what they do not have. There are many cases where it is obvious that Charlotte wants to be married and that she is trying to fulfill her mother’s dream of her being married off. Also Charlotte seems to ravish in the idea that someone else could take care of her. As for Mr. Collins, there is much detail linked to his attraction to Charlotte and being attracted to her could promote a stronger desire in him to fulfill his sexual desires with her. Also prior to Mr. Collins being with Charlotte, Mr. Collins was more interested in Elizabeth who continuously denied him and didn’t want to be with him. This further promotes that Mr. Collins did not show that he was truly in love with Charlotte in the story (Austen 211). There were many other key points that were involved in the relationship between Mr. Collins and Charlotte. This relationship between Charlotte and Mr. Collins did cause some problems for Charlotte as her sister was disappointed in her in that she felt that Charlotte should hold out for true love and really find someone who was smitten with her where as Charlotte seemed ready to settle in a desperate attempt to be married and no longer have to worry about whether or not she was going to have to take care of herself. Charlotte seemed to be comforted by the fact that someone was offering to really take care of her and focus their energies on her well being. In this fact it seems as though Charlotte was truly willing to settle for anything when it came to being taken care of and Mr. Collins was happy settling for Charlotte whom he found attractive and yet he was also able to encourage a relationship where he would be able to have passion in his own eyes. This relationship personifies the trend of the times that was when someone married for economic reasons rather than marrying for love (â€Å"Pride and Prejudice† 3). In the relationship of Elizabeth and Mr. Darcy there are many different factors affecting how things. In the beginning it seems as though Elizabeth can not stand Mr. Darcy, â€Å"as if intending to exasperate herself as much as possible against Mr. Dacry. † There were many other statements in the novel which would lead one to believe that Elizabeth indeed can not stand Mr. Darcy. There are also statements in the novel to support that Mr. Darcy feels likewise and the same and that he too has no intentions of having a relationship with Elizabeth. â€Å"Mr. Darcy, who was leaning against the mantle-piece with his eyes fixed on her face, seemed to catch her words with no less resentment than surprise. His complexion became pale with anger, and the disturbance of his mind was visible in every feature. † The problems between Elizabeth and Mr. Darcy seemed to be that they both were head strong and had big personalities in which they were not interested in being able to engage in a relationship together (Austen 313 and 314). Later through the novel the relationship between Elizabeth and Mr. Darcy develops and eventually, the second time that he proposes, they decide to be married. In this sense it seems as though Elizabeth holds out on marrying him until she believes that he is willing to initiate a relationship with her and he is willing to respect her for her thoughts and beliefs and not simply that he is attracted to her or wanting to be with her in a relationship. Another key factor in this relationship is that Elizabeth finds Mr. Darcy to be attractive, even when she is unhappy with who she thinks he is as a person, she still thinks that he is good looking. There are also a lot of issues in this sense as Elizabeth talks a lot throughout the first chapters about her opinions of others and she does not truly give others a chance to develop as she bases most of her long term impressions on others on the first impression which they make. Overall this relationship personifies a successful relationship between a man and a woman under the pretense that there has to be a long term connection and something more than initial attraction in order to have a successful relationship and marriage (â€Å"Pride and Prejudice† 1). In the relationship of Mr. and Mrs. Bennet it is obvious that Mrs. Bennet is consumed with the financial ability of men to take care of women. She is obsessed with her daughters being able to marry a â€Å"fine suitor† who will be able to provide for them and she is even talking about the amount of money one young man makes with her husband as the story opens. Mr. Bennet seems to be concerned about his wife’s beauty which would prove that he has a need and a desire to find her attractive. Mrs. Bennet’s only concerns for her daughters are that they be married off to wealthy men who can provide the best of life for them however she has poor public manners and many times her daughters are embarrassed by her. Also Mrs. Bennet’s actions really do keep some of the most suitable suitors away from her daughters as her actions are rather appalling to others and therefore they are typically wanting less to do with her daughters in fear of having to deal with her. In many parts of the novel, Mr. Bennet comments on his appreciation for Mrs. Bennet’s beauty, in doing so he is portraying that he is truly attracted to her and therefore he would be interested in the sexual relationships that would be available to him with his wife (Austen 213). This relationship between Mr. and Mrs. Bennet personifies the relationship that can occur when someone focuses on attraction first. This being that Mr. Bennet fell in love with how Mrs. Bennet looked without knowing what her intelligence was or whether or not they would get along. Mr. Bennet had been more concerned with these outward features than long term compatibility and in the end there were a lot of reasons to believe that this relationship was not all that it seemed to be (â€Å"Pride and Prejudice† 2). In the book, Pride and Prejudice by Jane Austen, there are many relationships that exemplify the idea that women are in relationships in order to secure stability and men are in relationships for sex. This is apparent in the relationships between Charlotte and Mr. Collins, Elizabeth and Mr. Darcy, and Mr. and Mrs. Bennet. In these relationships the women are looking for various securities whether financial, emotional or both and the men seem to be looking for the sexual benefits that will come from the relationships. These types of relationship trends are interested in Bibliography Austen, Jane. The Complete Novels. New York: Penguin Group, 2006. LeFraye, Deidre. Jane Austen: The world of Her Novels. New York: Harry N. Abrams, 2002. â€Å"Pride and Prejudice. † The Literature Network. 2000.

All Men Are Created Equally, a Contradiction Essays

All Men Are Created Equally, a Contradiction Essays All Men Are Created Equally, a Contradiction Paper All Men Are Created Equally, a Contradiction Paper Smith 1 James Smith English 101-28 Short Answer Response #3 09/12/2012 All Men are Created Equally: A Contradiction Over the centuries america has fabricated the cultural mythology that all men are created equally. For years america has enforced that all men are created equally when in fact the statement itself is a contradiction. Years ago certain people could not vote because of slavery, race, and also gender. Also America has social classes that have always been vivid in american culture. Finally this cliche holds very little currency in this nation now. Before and during the era of the civil war, slavery was a huge issue for many reasons. One of the biggest issues was that even though they were heman and on american soil; they were not allowed to vote. At this time in history slaves were not able to vote because they were considered â€Å"Property. † â€Å"Slaves were considered property, and they were property because they were black. (â€Å"PBS. org†)† How is property supposed to vote, right? Even though they were considered property, they were still human. If all men were created equally, as the constitution stated, then the slaves should of had the right to vote. Unfortunately they did not obtain this right until 94 years later. After slavery was abolished, there was still a problem. Certain people were not allowed to vote because of their race and gender. Again, all of these humans are supposed to be created equally, yet because of race and gender they are denied basic human rights. It would take another 94 years until the passage of the Voting Rights Act of 1965 for any of these people to be able to vote. So apparently all men are created equally unless they are a different gender or race. By living in america, you automatically become apart of a social class. America consists of four social classes: an upper class, working class, middle class, and finally a lower class. Smith 2 James Smith English 101-28 Short Answer Response #3 09/12/2012 America should not even have social classes if all men are created equally. If all men are created equally, then everyone would be making the same amount of money, have the same education, and etc. This surely is not the case. Results from these three research methods suggest that in the united states today, approximately 15 to 20 percent are in the poor, lower class; 30 to 40 percent are in the working class; 40 to 50 percent are in the middle class; and 1 to 3 percent are in the rich upper class. (â€Å"CliffsNotes†)† There is a wide variety of different people in different social classes. This fact completely contradicts that all me n are created equally because clearly they are not if america divides itself into different social classes. This particular cliche holds very little currency in this nation today. It still has some value though; by this i mean anyone who is an actual citizen of the united states can vote. Other than that it holds no currency. This cliche still lingers around because it gives people a sense of satisfaction. It gives people satisfaction because they think that even though that person is richer than me, or is different from me in any way; we still have the same rights and same penalties. Therefore this phrase will stick around until people realize that it is a contradiction and cultural mythology; eventually they will become unsatisfied with it. America has fabricated that all men are created equally. As you read, you realized that the phrase itself is a cultural mythology and contradictory. There are countless other reasons why this cliche is contradictory. You now know that slavery, race, gender, and social class play a vital role in proving this. Smith 3 James Smith English 101-28 Short Answer Response #3 09/12/2012 . Conditions of Antebellum Slavery. PBS. org. PBS, 01 Aug 2012. Web. 12 Sep 2012. . . Types of Social Classes of People. CliffsNotes. CliffsNotes, n. d. Web. 12 Sep 2012. .

Determination of the optimal level of production Essays

Determination of the optimal level of production Essays Determination of the optimal level of production Essay Determination of the optimal level of production Essay As we can see the determination of the break-even point provides valuable information to management. For instance, by comparing the targeted sales volume with the break-even point management can see the margin of safety of the firm. We have to remember that in the planning stage the forecasted sales revenue and costs are highly uncertain. Sales volume, for example, may drop due to an unforeseen competitors move. Costs may also be affected heavily by general increase in prices due to changes in governmental policy or other related factors.In view of the above management should also seek a sufficient margin of safety that provides reasonable assurance on the going concern of the firm in view of unanticipated changes. Economists extensively emphasize the determination of the optimal level of production. In this respect we will adopt the economist’s approach towards cost-volume profit analysis in determining the optimal level of production rather than the accountant’s approach. A break-even chart for an economist would appear as follows.The total cost and total revenue functions are non-linear. With respect to the total cost function the firm at low volumes of output experiences an increasing marginal cost2. Its effect however diminishes as output rises leading to a decreasing marginal cost. The reason behind the aforesaid effect of costs lies in the range of output covered by the economists approach. Unlike the accounting model, which has been utilised in the section 5. 1. 1, the economist’s model considers a wider range of output levels leading necessary the consideration of changes in factors of production efficiency.The effect on the form of the revenue function depends on the type of market structure the firm is operating in. Under the accounting model as shown in figure 5. 1 a straight line revenue function is the result of a firm operating under perfect competition3, thus being regarded as a price taker4. However, under the economists model in figure 5. 2 we considered imperfect market conditions whose revenue function is disturbed by marketing activities like promotion policies and competitive moves, leading to non-linear total revenue curve.The economic approach relies on the opportunity costs that comprise a normal rate of profit. This normal rate of profit is considered as the point that a firm is required to meet in order to continue operating. The normal rate of profit is shown as break-even point 1 in figure 5. 2. In view of the above, cost-volume profit analysis under the economist approach reveals the output level at which profit maximisation is achieved.At this output level the firm achieves the maximum short-run profits available in the market. Effective management should always try to reach the profit maximisation point in order to utilise the factors of production in the best way possible. In this respect cost-volume profit analysis also helps management to be effective in reaching the optimal activity level. Cost-volume profit analysis can also support management in the calculation of the most appropriate sales mix that leads to profit maximisation.Therefore it helps management to focus at the planning stage on the products that lead to the highest revenue. Let us further illustrate this point with the following hypothetical example: Let us assume that Auto Ltd. is engaged in the manufacturing of three types of cars, standard, off road and sport cars. The management of the company is analysing which are the most profitable products in order to focus their advertising and promotion activities on to meet or if possible even exceed the expected level of sales.The finance director of the firm stated that the business enterprise could afford to spend an additional ? 1,000,000 advertising expenditure during the year. This expenditure can be distributed on the products in accordance to the management discretion. For simplicity we will consider the effect of spending all this additional advertising costs on one product only. A useful tool that can be used in cost-volume profit computations is spreadsheets. Indeed an excel spreadsheet was used to calculate the cost-volume profit analysis both in units and in revenue.

Introduction to management Essay Example | Topics and Well Written Essays - 1000 words - 1

Introduction to management - Essay Example This scenario may be referred as dynamicity of the environment. The shorter termed opportunities and speculation points cannot be integrated in the previously designed strategic plan of the organization (Steed, 2013). Conventional strategic plans are not flexible to absorb the environmental developments while the previous plan is being implemented. The strategic plans are result oriented, but the minor flexible slots can provide the short term advantage to the competitors. The environment of the organization apparently remains unchanged and stationary. The previously stated phenomenon creates rigidity because of mission and vision statements. Mission and vision statement are the guides for future time period. The frame work for future time is usually for longer time period and once it is created, no one can add newer dynamics into the objectives’ timeline. However it is not a rule of thumb because some strategic plans have the capability to recognize the importance of the envi ronment but only to the extent of locked in objectives. The extent of absorbability is not significant to compete over the cutthroat bases (Burus, 2013). Strategic planning possesses vital importance in the strategic success of an organization. There are meaningful rationales behind creation of strategic plans. Foremost, the strategic plans provide an enlightened way to create the organizational goals fulfilled. It puts the synergy in to the organizational energies by providing a leading path definition. The leaders within the organizations have clear idea of expected output from the subordinate and the employees gain a transparent spirit of anticipations. The exchange of expectations creates a bridge like roadmap through which the organization personnel lead their tasks. The concept of cross functional work teams and self managed teams has significantly twisted the scenario. Increasing competition has augmented the need of organizational commitment and innovative environment. For e xample, Google Incorporation provides one an hour to its employees which is spare of the routine tasks so that they can have a brain storming session and come up with the innovative ideas. Recognizing the importance of the strategic planning, we cannot recommend letting the strategic plans go. It needs to create integration with dynamicity of the environment with the organizational strategic plan (Steed, 2013). Leading innovative organizations in the world are leaning to transfer their organizational structures from mechanistic to organic ones. The flatter organizational hierarchies provide a wider room for innovation and dynamicity absorption. At the same time it is required to create linkage between external changes and the current organizational strategy. However it still prevails like a major decision to be taken in the milieu of large organizations. The cultural and team work constraints are enough significant that organizational strategy has a little space to roll over the sma ll changes (Slezek, 2013). Dynamicity absorption is suggested to attain through flexible mission and vision statements. In the conventional settings, it almost seems to be impossible to stick with the environmental changes along with implementing a rigid, long term and result oriented organizational

Brand Aston Martin Essay Example | Topics and Well Written Essays - 750 words

Brand Aston Martin - Essay Example Commonly, brands in all markets are evaluated by referring to their attributes. These attributes can be classified into two main categories: symbolic and functional (Sinkovics & Ghauri, 2009, p.186). Symbolic attributes refer to the intangible benefits that a brand can offer to consumers; for example, a mobile phone of a particular brand can be related to a specific social status of the owner. Functional attributes refer to technical/ practical benefits of a brand, meaning the functional benefits that a brand can offer to consumers (Sinkovics & Ghauri, 2009, p.186); the increased functionality of a mobile phone of a brand compared to the similar device of another brand is a common example of functional attribute (Sinkovics & Ghauri, 2009, p.186). Emotional attributes have also become an important category of brand attributes. Emotional attributes reflect ‘the feelings of consumers about a retail brand’ (Floor 2006, p.222). These feelings can be influenced by the function al attributes of the brand (Floor 2006, p.222); still, emotional attributes are depended on all aspects of a brand, as included in the brand personality. Functional, emotional and symbolic attributes are often used for describing a brand’s personality (Floor 2006, p.222). The functional and emotional attributes of brand Aston Martin can be characterized as quite significant. These attributes could be described as follows: in terms of their performance, Aston Martin cars have been classified as of exceptional value.